Demurashvili Georgy, Davarpanah Keyvan, Szmukler-Moncler Serge, Davarpanah Mithridade, Raux Didier, Capelle-Ouadah Nedjoua, Rajzbaum Philippe
Excellence in Dentistry research group, Paris, France.
Department of Prosthetics, Hôpital Charles Foix, Paris Descartes University, Paris, France.
Clin Implant Dent Relat Res. 2015 Oct;17(5):923-31. doi: 10.1111/cid.12192. Epub 2013 Dec 27.
Treating the edentulous patient with a gingival smile requires securing the prosthesis/soft tissue junction (PSTJ) under the upper lip.
To present a simple method that helps achieve a predictable aesthetic result when alveoplasty of the anterior maxilla is needed to place implants apical to the presurgical position of the alveolar ridge.
The maximum smile line of the patient is recorded and carved on a thin silicone bite impression as a soft tissue landmark. During the three-dimensional radiographic examination, the patient wears the silicone guide loaded with radiopaque markers. The NobelClinician® software is then used to bring the hard and soft tissue landmarks together in a single reading. Using the software, a line is drawn 5 mm apical to the smile line; it dictates the position of the crestal ridge to be reached following the alveoplasty. Subsequently, the simulated implant position and the simulated residual bone height following alveoplasty can be simultaneously evaluated on each transverse section.
An alveoplasty of the anterior maxilla was performed as simulated on the software, and implants were placed accordingly. The PSTJ was always under the upper lip, even during maximum smile events. The aesthetic result was, therefore, fully satisfactory.
This simple method permits the placement of the PSTJ under the upper lip with a predictable outcome; it ensures a reliable aesthetic result for the edentulous patient with a gingival smile.
对于牙龈微笑的无牙颌患者，需要将修复体/软组织交界（PSTJ）固定在上唇下方。
提出一种简单的方法，当需要对上颌前部进行牙槽骨成形术以将种植体放置在牙槽嵴术前位置的根尖方向时，有助于获得可预测的美学效果。
记录患者的最大微笑线，并将其刻在薄硅胶咬合印模上作为软组织标志。在三维影像学检查期间，患者佩戴装有不透射线标记物的硅胶导板。然后使用NobelClinician®软件在一次读数中将硬组织和软组织标志结合起来。使用该软件，在微笑线根尖方向5mm处画一条线；它决定了牙槽骨成形术后要达到的牙槽嵴顶位置。随后，可以在每个横断面上同时评估模拟的种植体位置和牙槽骨成形术后模拟的剩余骨高度。
按照软件模拟的方式对上颌前部进行了牙槽骨成形术，并相应地植入了种植体。即使在最大微笑时，PSTJ也始终位于上唇下方。因此，美学效果完全令人满意。
这种简单的方法能够将PSTJ置于上唇下方并获得可预测的结果；它为牙龈微笑的无牙颌患者确保了可靠的美学效果。
